Abstract
Deliberate self-harm behavior (DSH) can have profound effects on a person’s quality of life, and challenges the health care system. Even though DSH has been associated with aggressive interpersonal behaviors, the knowledge on DSH in persons exhibiting such behaviors is scarce. This study aims to (1) specify the prevalence and character of DSH, (2) identify clinical, neurocognitive, psychosocial, and criminological characteristics associated with DSH, and (3) determine predictors of DSH among young violent offenders. Data were collected from a nationally representative cohort of 270 male violent offenders, 18–25 years old, imprisoned in Sweden. Participants were interviewed and investigated neuropsychologically, and their files were reviewed for psychosocial background, criminal history, mental disorders, lifetime aggressive antisocial behaviors, and DSH. A total of 62 offenders (23%) had engaged in DSH at some point during their lifetime, many on repeated occasions, yet without suicidal intent. DSH was significantly associated with attention deficit hyperactivity disorder, mood disorders, anxiety disorders, various substance use disorders, being bullied at school, and repeated exposure to violence at home during childhood. Mood disorders, anxiety disorders, and being bullied at school remained significant predictors of DSH in a total regression model. Violent offenders direct aggressive behaviors not only toward other people, but also toward themselves. Thus, DSH must be assessed and prevented in correctional institutions as early as possible, and more knowledge is needed of the function of DSH among offenders.
Highlights
Self-harm is a serious self-destructive behavior that implies psychological suffering, can have long-term and profound effects on a person’s quality of life, and challenges the health care system [1, 2]
Identify clinical, neurocognitive, psychosocial, and criminological characteristics associated with Deliberate self-harm behavior (DSH) among young adult violent male offenders; and
Forty-eight offenders (18%) reported suicide attempts: 22 had made one suicide attempt, 25 had made multiple (2– 6) attempts, and one participant reported as much as 15 suicide attempts
Summary
Self-harm is a serious self-destructive behavior that implies psychological suffering, can have long-term and profound effects on a person’s quality of life, and challenges the health care system [1, 2]. Acts typical of DSH include cutting, burning, biting, scratching or excessively rubbing the skin, self-hitting, head-banging or hitting fists against objects, ingesting a substance, drug, or object and jumping from a height with the intent of causing selfharm [5]. Suicide rates in prison have been reported to be three to six times higher than in the general population [15, 16]. In one study the risk of suicide was higher in those who self-harmed than in the general prison population, and more than half of the deaths occurred within a month of self-harming [17]. Studies have found that childhood abuse increases the risk of DSH in adolescence and adulthood [25, 26,27], and recent bullying victimization and expulsion from school have been associated with DSH [28]
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